Retrospective audit of paediatric intracranial tumours treated in Universitas Hospital from 2000-2020

Abstract

The research involved a retrospective review of the number and types of paediatric tumours managed at Universitas Hospital, Bloemfontein, over 20 years. Universitas is the only referral hospital serving the Free State province and the surrounding areas, including the Northern Cape and Lesotho, in relation to paediatric tumours. The total population of the Free State, Northern Cape, and Lesotho numbers at least 6 million, and the area has only one hospital to manage paediatric tumours. Paediatric tumours are treated in cooperation by the neurosurgery and the paediatric oncology departments of Universitas Hospital. This collaboration is due to the multidisciplinary approach needed to treat this pathology adequately. The objective of this research was to review the different types of tumours encountered and managed by the hospital. An investigation was done into the demographics of patients presenting at the hospital from 2000 to June 2020. The data that was collected clarified the patient gender and age distribution, and also the outcomes achieved during the given period. A review of the management of the patients was done, and a comparison made of reviewed data and literature reporting on international statistics. The research was undertaken with the aim of optimising the management of pediatric oncology patients, and to streamline data collection. As Universitas is a teaching institution, achieving these aims may help upcoming registrars in both neurosurgery and paediatric oncology to have a better understanding of a disease that affects this fragile population. The research conducted is a retrospective review of paediatric intracranial tumours admitted to Universitas hospital during the period ranging from 2000 to 2020 (June). It looks at the different types of tumours admitted and the management thereof by the departments involved; neurosurgery and paediatric oncology. During this period 274 patients were managed with 60% of the patients dying after receiving surgery and or adjuvant treatment. Of the 274 patients, most tumours were glial in origin with medulloblastomas and ependymomas being second and third most, respectively. Patients received radiotherapy and oncotherapy according to paediatric protocols; after a biopsy or resection by neurosurgery. Patients would also get cerebrospinal fluid diversion if required. This diversion was seen as prophylactic management in patients that could not receive a complete resection of the tumour. This research revealed a need for better notekeeping and storage of patient data when it comes to tumours, ensuring that future research will be of greater quality. Research also revealed that a more thorough examination of tumours in teenagers will need to be conducted. This research will help in compiling a better template in admission of all tumours in Universitas and thereby facilitate an extensive tumour registry for the neurosurgery department.